Osteomyelitis yog ib qho kab mob ntawm cov pob txha thiab ib puag ncig cov ntaub so ntswg, uas tshwm sim los ntawm lawv cov kab mob pyogenic. Cia peb saib cov lus qhia txog tus kab mob. Kev saib xyuas tshwj xeeb yuav raug them rau hom kab mob xws li mob osteomyelitis. Peb yuav kawm txog qhov ua rau nws tshwm sim, txoj kev kuaj mob thiab kev kho mob.
Osteomyelitis: kab mob kev faib tawm
Raws li ntau yam, muaj ntau yam kev faib tawm ntawm tus kabmob. Nyob ntawm cov xwm txheej rau qhov tshwm sim ntawm tus kab mob, nws tuaj yeem yog:
- primary (hematogenous);
- secondary (post-traumatic);
- odontogenic.
Hematogenous osteomyelitis tshwm sim los ntawm kev nthuav qhia cov kab mob hauv cov ntshav mus rau hauv cov pob txha cov ntaub so ntswg los ntawm cov qhov txhab purulent, pustules ntawm daim tawv nqaij lossis inflammatory foci ntawm cov kab mob hauv nruab nrog cev. Feem ntau, hom kab mob no cuam tshuam rau menyuam yaus. Hematogenous osteomyelitis pib tam sim ntawd thiab thawj hnub yog nrog cov tsos mob ntawm intoxication ntawm lub cev: kub taub hau, xeev siab, ntuav,general tsis muaj zog, mob taub hau. Tom qab qee lub sijhawm (txog li ob hnub), qhov o ntawm cov ceg ceg tshwm sim, uas yog nrog los ntawm qhov mob hnyav.
Post-traumatic osteomyelitis tuaj yeem tshwm sim tom qab phais pob txha, qhib pob txha, lossis phom phom. Qhov no tshwm sim nyob rau hauv lub xub ntiag ntawm contributing yam, xws li, piv txwv li, tsis muaj los yog tsis tsim nyog kev kho mob ntawm kev phais, lub xub ntiag ntawm loj hematomas los yog txawv teb chaws lub cev. Tag nrho cov ntawm lawv txhawb txoj kev loj hlob ntawm cov kab mob, raws li lawv cuam tshuam nrog cov txheej txheem zoo.
Nws yog kev cai xa mus rau odontogenic osteomyelitis rau ib pab pawg. Nws yog ib qho txheej txheem inflammatory hauv cheeb tsam maxillofacial. Odontogenic osteomyelitis cuam tshuam rau cov nqaij mos thiab cov hniav, yog li tus kab mob muaj feem xyuam nrog kev kho hniav. Hom kab mob no nrog mob taub hau, ua npaws thiab tsis muaj zog ntawm lub cev. Nrog nws txoj kev loj hlob tuaj, tej zaum yuav nyuaj rau nqos, qhov tsos ntawm qhov ua tsis taus pa, o ntawm cov mucous daim nyias nyias, cov quav hniav ntawm tus nplaig.
Cov qauv hauv qab no ntawm osteomyelitis, uas peb yuav xav txog, nyob ntawm seb nws qhov xwm txheej:
- ntsim;
- mob.
Raws li txoj cai, kev kho mob pib pib ntawm thawj theem ntawm tus kab mob. Tab sis thaum tsis muaj kev kho mob txaus, mob osteomyelitis yuav mob ntev.
Cov kab mob hauv qab no tsis tshua muaj:
- Olie's syndrome;
- Body's abscess;
- Garre kab mob.
Yog li, peb tau paub txog cov ntaub ntawv dav dav txog osteomyelitis. Nws yog lub sijhawm los saib xyuas nws daim ntawv ntev.
Ua rau kab mob
txhawm rau nrhiav qhov ua rau mob osteomyelitis ntev, koj tsis tas yuav tshawb nrhiav ntev. Nws twb tau hais saum toj no tias tus kab mob tshwm sim los ntawm kev kho tsis raug ntawm nws daim ntawv mob.
Tus neeg sawv cev ua rau mob osteomyelitis nyob rau hauv feem ntau yog Staphylococcus aureus. Txawm hais tias muaj cov xwm txheej thaum pom tus kab mob tuaj yeem ua rau Pseudomonas aeruginosa, fungus, Proteus, E. coli.
Yog li, lub ntsiab ua rau mob osteomyelitis:
- lig kev txheeb xyuas ntawm tus kab mob ua rau tus kab mob;
- kho tsis raug ntawm daim ntawv mob hnyav;
- Kev txheeb xyuas tsis tu ncua ntawm lub hauv paus ntawm tus kab mob sib kis.
Symptoms of disease
Txoj kev mob osteomyelitis yuav loj hlob nyob ntawm qhov chaw ntawm qhov chaw, qhov chaw thiab qhov tshwm sim ntawm cov txheej txheem inflammatory. Feem ntau, tus kab mob kuj cuam tshuam rau cov ntaub so ntswg uas nyob ib sab ntawm qhov cuam tshuam.
mob osteomyelitis yog yam ntxwv los ntawm:
- daim tawv nqaij blanching;
- poob qab los;
- pw tsis tsaug zog;
- pom ntawm apathy thiab lethargy.
Tsis tas li ntawd, thaum lub sij hawm kev loj hlob ntawm tus kab mob, purulent fistulas feem ntau tshwm sim. Thaum raug cov ntaub so ntswg nyob sib ze, tsim cov abscesses, phlegmon tsis suav nrog.
YogCov kab mob osteomyelitis ntev tau cuam tshuam rau lub puab tsaig sab hauv, tej zaum yuav muaj cov qog ntshav nce ntxiv.
Ntxiv rau tag nrho cov no, tus kab mob no nrog rau kev tsis zoo ntawm kev noj qab haus huv, cov cim qhia ntawm kev qaug cawv thiab mob siab rau hauv thaj tsam ntawm lub cev puas tsuaj: lub xub pwg lossis femur pob txha, vertebrae, thiab lwm yam.
Kev kuaj kab mob
txhawm rau txheeb xyuas cov kab mob osteomyelitis ntev, koj tuaj yeem tiv tauj tus kws kho mob, kws phais, orthopedist. Kev kuaj mob yuav suav nrog ntau yam haujlwm.
Tus neeg mob tuaj yeem sau tau:
- Qhia, tshuaj xyuas, palpation.
- X-ray. X-ray tuaj yeem pom cov qauv hloov pauv ntawm cov pob txha thaum ntxov li ib lub lis piam tom qab pib tus kab mob.
- Biochemical thiab ua tiav cov ntshav txhawm rau txiav txim siab erythrocyte sedimentation tus nqi thiab muaj lossis tsis muaj tus neeg sawv cev.
- Cytological thiab bacteriological kev kuaj tawm ntawm qhov txhab, fistula thiab pob txha pob txha.
- Ultrasound ntawm thaj chaw puas. Nws yog ib qho tsim nyog los kuaj xyuas cov kua dej sib xyaw.
- Angiography. Nws tau ua tiav txhawm rau txhawm rau txheeb xyuas cov chaw tsis muaj ntshav txaus.
- Sib nqus resonance thiab suav tomography. Nws yog ua tiav thiaj li yuav tau txais cov ntaub ntawv hais txog qhov loj, thaj chaw, kev faib tawm thiab qhov xwm txheej ntawm kev hloov pauv pathological.
- kev tshawb fawb Radionuclide yog qhov tsim nyog rau kev tshawb pom tus kab mob raws sijhawm, nws qhov hnyav thiab qhov xwm txheej ntawm cov txheej txheem inflammatory.
Nws raug nquahu kom tsis txhob kuaj xyuas sab nraud thiabsiv x-ray, tab sis kuj nrhiav sijhawm rau kev kuaj mob siab tshaj plaws, txij li qhov no tsuas yog tuaj yeem xaiv qhov kev kho mob zoo tshaj plaws.
Differential Diagnosis
mob osteomyelitis hauv nws cov tsos mob yuav zoo ib yam li lwm yam kab mob. Yog li ntawd, kev kuaj mob sib txawv yog qhov tseem ceeb heev. Nws yuav pab tsim kom muaj kev kuaj mob kom raug thiab sau ntawv kho tau zoo.
Cov chav kawm ntawm osteomyelitis tuaj yeem zoo ib yam li:
- tshwm sim ntawm neoplasms ntawm pob txha;
- pob txha tuberculosis;
- osteochondropathy;
- fibrous osteodysplasia.
kev kho mob
Kev kho mob ntawm tus kab mob no suav nrog kev siv tshuaj pleev ib ce: sorbents, tshuaj pleev tiv thaiv kab mob, proteolytic enzymes, thiab tshuaj tua kab mob.
Kev mob tshwm sim thiab hom kab mob osteomyelitis xav tau ntau hom kev kho:
- tshem tawm toxins nrog rau cov dej ntsev, "Rheopolyglucin" thiab lwm yam tshuaj;
- tshuaj tua kab mob nrog kev siv cov tshuaj tua kab mob pob txha-tropic lossis kev npaj tshwj xeeb thaum kuaj pom cov kab mob;
- tiv thaiv kab mob nrog kev qhia tshwj xeeb ntawm staphylococcal toxoid, autovaccine.
kev kho mob phais
Kev xav tau kev phais mob tshwm sim thaum muaj coob tussequesters uas tsis daws raws sijhawm. Qhov no tseem tuaj yeem suav nrog kev tsim fistula lossis muaj kab mob raum hnyav hauv tus neeg mob.
Thaum muaj mob osteomyelitis, kev kho mob phais suav nrog ntau cov txheej txheem yuav tsum tau ua:
- tshem tawm cov ntaub so ntswg uas tsis tuaj yeem;
- kho qhov txhab nrog tshuaj tua kab mob thiab tshuaj tua kab mob;
- plasty ntawm cov ntaub so ntswg thiab pob txha;
- muag dej;
- Kev txhim kho lub catheter rau hauv cov hlab ntsha, uas nyob ib sab ntawm qhov txhab. Qhov no yog qhov tsim nyog rau kev siv tshuaj tua kab mob ntxiv los ntawm nws.
Physiotherapy
Kab mob Osteomyelitis yuav tsum tau kho thiab lub cev yam. Lawv lub hom phiaj tseem ceeb yog txhawm rau tshem tawm qhov mob, ua kom cov txheej txheem rov qab, ua kom cov txheej txheem sequesters, txo lub cev rhiab rau cov kab mob, thiab txhawb kev tiv thaiv.
Txhawm rau txo cov kev ua ntawm cov txheej txheem inflammatory, tus neeg mob tuaj yeem raug tshuaj:
- infrared laser kho;
- UHF txoj kev kho;
- erythemal koob tshuaj ntawm UV hluav taws xob;
- UHF txoj kev kho.
Cov txheej txheem saum toj no tsuas yog ua nrog kev kho tshuaj tua kab mob thiab yog tias muaj txoj hauv kev rau kev tawm ntawm fistula (pus).
Yuav kom ceev cov txheej txheem ntawm cov ntaub so ntswg kho yog siv:
- kho mob ultrasound;
- electrophoresis txhais tau tias txhim kho cov metabolism ntawm cov vitamins thiab tshuaj;
- peloid therapy;
- high-frequency magnetotherapy;
- daim ntawv thov paraffin thiab ozocerite.
Thaum lub sijhawm mob osteomyelitis hauv kev zam txim, calcium chloride electrophoresis tau ua. Txhawm rau nthuav dav cov hlab ntsha hauv thaj tsam cuam tshuam, electrophoresis ntawm vasodilators tuaj yeem siv.
txhawm rau txhim kho cov txheej txheem metabolic hauv cov ntaub so ntswg sib txuas, koj xav tau:
- kho mob ultrasound;
- transcutaneous hluav taws xob stimulation;
- radon thiab hydrogen sulfide da dej;
Nyob rau theem ntawm kev tshem tawm cov mob osteomyelitis, pelotherapy thiab kev kho tsawg zaus yog siv los txo cov kev ua ntawm cov ntshav coagulation system.
Txhawm rau qhib lub cev tiv thaiv kab mob, tus neeg mob raug sau tseg:
- heliotherapy;
- electrophoresis ntawm cov tshuaj uas cuam tshuam rau immunomodulation;
- siab-frequency magnetotherapy hauv cheeb tsam thymus;
- suberythemal koob tshuaj tiv thaiv UV;
- laser ntshav irradiation.
Txhawm rau tshem tawm cov co toxins, tus neeg mob yuav tsum haus dej sodium chloride hydrocarbonate ntxhia dej peb zaug hauv ib hnub ("Essentuki No. 4", "Borjomi" thiab lwm yam).
txhawm rau txhim kho cov pa oxygen rau cov ntaub so ntswg, oxygen barotherapy lossis ozone da dej tuaj yeem siv.
Contraindications rau physiotherapy
Txawm hais tias kev kho mob nrog rau lub cev muaj txiaj ntsig zoo, muaj ntau qhov xwm txheej thaum nws raug txwv nruj heev. Cov no suav nrog cov xwm txheej uas tus neeg mob muaj:
- lub cev kub;
- septicopyemia;
- pronounced qaug cawv;
- abscesses hauv qhov tsis muajcov kua paug tawm.
Txoj kev tshwm sim ntawm tus kab mob ntev
mob osteomyelitis tuaj yeem ua rau muaj qhov tshwm sim loj heev thiab ua rau muaj kev phom sij rau lub neej. Tus kab mob tuaj yeem ua rau fibrous dysplasia, uas, dhau los, tuaj yeem ua rau cov qog nqaij hlav. Nyob rau hauv cov ntaub ntawv no, cov pob txha cov ntaub so ntswg ua caws pliav, thiab cov kua paug pib kis tshaj nws. Thaum lub sijhawm no, ntshav lom tuaj yeem ua rau tuag taus.
Kev kho tus kab mob tsis tu ncua tuaj yeem ua rau cov tsos mob ntawm hematogenous osteomyelitis. Nws yog tus cwj pwm los ntawm cov tsos ntawm cov sequesters loj thiab cov txheej txheem purulent uas nws kim heev. Tag nrho cov no yog nrog los ntawm metastasis mus rau hauv lub cev.
Ntxiv rau txhua yam, nws tsim nyog sau cia tias osteomyelitis cuam tshuam tsis yog cov pob txha nkaus xwb, tab sis kuj tseem muaj lwm yam kabmob: lub siab, ob lub raum, endocrine system. Kev kho tsis raws sijhawm tuaj yeem ua rau lub raum tsis ua haujlwm thiab tuag ntawm tus neeg mob.
Kev Tiv Thaiv Kab Mob osteomyelitis
Peb kawm txog cov kab mob xws li osteomyelitis. Kev faib tawm, cov tsos mob thiab kev kho mob tau raug tham hauv kab lus. Nws tseem yuav nco txog ib qho teeb meem tseem ceeb dua. Puas muaj txoj hauv kev los pab kom tsis txhob muaj mob?
Kev tiv thaiv kab mob osteomyelitis ntev yog kev kho raws sijhawm ntawm nws daim ntawv mob. Twb tau thawj cov tsos mob ntawm tus kab mob, koj yuav tsum nrhiav kev pab tsim nyog. Tom qab tag nrho, raws li koj paub, nws yooj yim dua los tiv thaiv qhov teeb meem tsis tshwm sim dua li siv koj lub neej tag nrho nrog nws.sib ntaus.
